HomeMy WebLinkAbout11-28-07 (3)
REV:1500 EX . (6-00)
I OFFICIAL USE ONLY
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
1------------ ---- - -- --. .
i FILE NUMBER
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II
07
00867
COLLN1Y_~QD_E 'LE-,^>B
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SOCIAL SECURITY NUMBER
__f'j~ll-~B
. ![)ECEDENTS-NAME(lAST.FIRST.ANOMIODLE-INITIAL)
,
: Helfer, Anna M.
l OATT6FDEATH(MM-DD-YEAR)---~TDATE-6FBIRTH (MM::D6:YEAR)-
178-18-6925
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THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
i__0_8-~1-2007___-__-_--_-,_ p~-q~_-1916
'(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST. FIRST AND MIDDLE INITIAL)
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
3. Remainder Return (dale of death pnor 1012-13-82)
l__ 2, Supplemental Return
X 1, Original Return
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4a. Future Interest Compromise (date of death after
12-12-82)
Decedent Died Testate (Attach 7. Decedent Maintained a Living Trust (Attach
copy of Will) copy of Trust)
9. Litigation Proceeds Received - 10. Spousal Povertv Credit (date of death between 11, Election to tax under Sec. 9113(A) (Attach Sch 0)
12-31-91 and 1-1-~5)
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!Z : NAME I COMPLETE MAILING ADDRESS
~ 1_ David J. Lenox______n_____~__________ !
lr i FIRM NAME (If applicable)
~ l!h!... Wiley~-.!oup, P~__~__
8 I TELEPHONE NUMBER
i 717 -432-9666
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i 1. Real Estate (Schedule A)
,
! 2. Stocks and Bonds (Schedule B)
5. Federal Estate Tax Retum Required
4. Limited Estate
8. Total Number of Safe Deposit Boxes
130 W. Church Street
, Dillsburg, PA 17019
i
I
OFFICIAL USE ONLY
(1 )
None
(2)
None
-,---------- - --~-----
(3) None
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(4) None
(5) 150,146.36
(6) 8,160.87 "--
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3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L) 0 Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
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8,487.73
1,232.53
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
(11 )
9,720.26
148,586.97
11. Total Deductions (total Lines 9 & 10)
(12)
12. Net Value of Estate (Line 8 minus Lirie 11)
(13)
0.00
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has
i not been made (Schedule J)
_____~_14. Net Value Subject to Tax (Line 12 minus Line 13)______~___~1~)
I SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
I
I 15.Amount of Line 14 taxable at the spousal tax rate,
I or transfers under Sec" 9116(a)(1.2)
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!16.Amount of Line 14 taxable at lineal rate
148,586.97
(15)
0.00
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0.00
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6,686.41
148,586.97
(17)
0.00
x .12
x .15
0.00
0.00
17. Amount of Line 14 taxable at sibling rate
(1B)
(19)
0.00
6,686.41
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
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Form REV-1500 EX (Rev. 6-00;
Copyright 2002 form software only The Lackner Group, Inc.
Decedent's Complete Address:
STREET ADDRESS
325 Wesley Drive
CITY Mechanicsburg
STATE PA
ZIP 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
6,686.41
334.32
Total Credits (A + B + C)
(2)
334.32
3. Interest/Penalty if applicable
D. Interest
E. Penalty
TotallnterestfPenalty (0 + E)
4. If line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
8. Enter the total of line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5)
(5A)
(58)
6,352.09
6,352.09
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.................................................................................. ~
b. retain the right to designate who shall use the property transferred or its income;.................................... 0
c. retain a reversionary interest; or.......................................... ....................................................................... ~
d. receive the promise for life of either payments, benefits or care?............................................................. [!J
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?. .......... ................... "'" .... ..' .... .... ..................... ........ ... ......... ..... ..... [!J
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... [!J
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
DATE
490 Seedling Ct. .)
__~e_c~an~sburg, PA_ 170~__.___ / 127:..
ADDRESS DATE ]===
ADDRESS
DATE
130 W. Church Street
DiIIsburg, PA 17019
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 119116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a
natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P .5. ~9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P .S.
~9116 1.2) [72 P.S. 99116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. S9116 (a) (1.3}). A sibling is
defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
fungilIill ann ULcBlamrnt
OF
ANNA M_ HELFER
BE
IT
REMEMBERED,
that
I,
ANNA M.
HELFER,
of
Mechanicsburg, Cumberland County, Pennsylvania, being of
sound mind, memory and understanding, de make, publish and
declare this as and for my Last Will and Testament, hereby
revoking and making null and void any and all Wills and
Testaments and writings in the nature thereof made by me at
any time heretofore.
ITEM 1:
I direct that all my just debts and funeral
expenses be paid as soon after my demise as may be
convenient.
-ITEM 2:
All the rest, residue and remainder of my
estate, of whatsoever nature and wheresoever situate, whether
it be real, personal or mixed, including property over which
I have a power of appointment, I give, devise and bequeath as
follows:
Ninety (90%) percent to my children Anne C. Landis and
Robert C. Jennings, in equal shares, or if predeceased to
their issue, per stirpes; and,
Ten (10%) percent to my husband's children, Linda Jean
Waters, Frank Paul Helfer, and Daniel Robert Helfer, in equal
shares, or if predeceased to their issue, per stirpes.
ITEM 3:
I direct my hereinafter named Executor to pay
all inheritance, estate, succession and legacy taxes of
whatsoever nature and kind, to which my estate or the
transfer of any property passing hereunder or otherwise
passing by reason of my demise, may be subject and to charge
such taxes against my residuary estate, it being my intention
that none of the aforesaid taxes, either federal or state, on
any property required to be included in my gross estate,
under the provisions of any state or federal law now in force
or hereafter enacted, shall be prorated among the persons
interested in my estate to whom such property is or may be
transferred or to whom any benefit accrues.
ITEM ~ I appoint my daughter and son, namely, Anne C.
Landis and Robert C. Jennings, as Co-Executors of this my
Last Will and Testament.
In the event either of the Co-
Executors is unable to fulfill the duties of the office, the
remaining Co-Executor may serve alone without necessitating
the appointment of a replacement.
ITEM 5:
I direct that my Executors or their successor
shall not be required to give bond for the faithful
performance of their duties in any jurisdiction.
ITEM 6:
My Personal Representatives shall have the
following powers in addition to those vested in them by Law
and by other provisions of this, my Last Will and Testament,
exercisable without court approval, and effective until
distribution of all property:
1. To retain any or all of the assets of my
estate, real or personal, without restriction
to investments authorized for Pennsylvania
fiduciaries, as they from time to time may deem
proper, without regard to any principal of
diversification or risk.
2. To invest in all forms of property without
restriction to investments authorized
for Pennsylvania fiduciaries, as they from
time to time may deem proper, without regard to
any principal of diversification or risk.
3. To sell at public or private sale, to exchange,
or to lease for any period of time, any real or
personal property and to give options for
sales, exchanges or leases, for such prices and
upon such terms or conditions as they from time
to time may deem proper.
4.
To allocate receipts and expenses to
or income or partly to each as they
to time may deem proper.
principal
from time
5. To borrow money from persons or institutions,
themselVEs included, and to mortgage or
pledge any or all real or personal
as they in their sole dIscretIon
wi thout regard LO the dispOSI ti ve
this instrument.
property
shall choose,
provisions of
6. To compromise any claIm or controversy asserted
by or against ~y estate or trust estate.
7. To make distribution In cash or in kind or
partly in cash and partly in kind, and in such
manner as they may determine, and at valuations
finally to be fixed by them.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this 13th day of September, 2006.
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{2~/'Y7,1~
ANNA M. HELFER
(SEAL)
.ff/a~ CLlt~~
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COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF YORl<.
We, ANNA M. HELFER, DAVID J. LENOX, ESQUIRE and MARCY K.
RENSHAW, the Testatrix and the w~tnesses respectIvely, whose
names are signed to the attached or foregoIng instrument,
being first duly sworn, do hereby declare to the undersIgned
authority that the Testatrix signed and executed the
instrument as her Last Will and Testament and that she had
signed willingly (or willingly directed another to sign for
her), and that she executed it as her free and voluntary act
for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the Testatrix,
signed this Last Will and Testament as witness and that to
the best of their knowledge the Testatrix was at the time
eighteen (18) years of age or older, of sound mind and under
no constraint or undue influence.
3
Rev-15G8 EX+ (6-98)
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Helfer, Anna M.
FILE NUMBER
21-07 -00867
ESTATE OF
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property joinlly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 Ashbury Communities, Inc. (Bethany Village refund):
VALUE AT DATE
OF DEATH
144.406.74
2 Capital Blue Cross (refund):
204.90
3 Highmark Insurance (refund):
23.20
4 Insurance refund:
101.00
5 Long Term Care Insurance (refund):
2,700.00
6 Misc. refunds:
56.70
7 PNC Bank Checking #5003218892:
2.653.82
TOTAL (Also enter on Line 5, Recapitulation)
150.146.36
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
, . --' /
PNC SA K ['2-70S-2]L]
1\ . L:~46
o PNCBAl\K
October 30, 2007
S. Dawn Gladfelter
130 W. Church Street, Suite 100
Di11sburg, PAl 7019
RE: Estate of Anna M. Helfer, deceased
SSN: 178-18-6925
DOD: 8/3112007
Dear Ms. Gladfelter:
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Checking Account
Account #5003218892
Establisbed 09/03/2003
ANNA N HELFER
The balance prior to the deposit was $453.62 (non-interest bearing). After the deposit on
the date of death (8/3112007) of$2,719.12 and after several deposits and a withdrawal it
took the total balance to $2,653.82 (non-interest bearing).
* 1 have obtained copies of the statements which r am faxing over that shows the activity
on the above account.
Savings Account
Account #5003783891
Established 1 0/06/2003
ANNA N HELFER
Closed on the date of death in the amount of $2,719.12 which was transferred to Checking
Account #50032) 8892.
Please note that this office only provides date of death balances for deposit accounts
(lRAs, CDs, Checking and Savings accounts). We do Dot process any financial
transactions or provide statements. If you need assistance with any of these items,
please call1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
~w~
RacheIle Wells
1-800-762-1775
P7-PFSC-04-F
500 first Ave.
Pittsburgh PA 15219
Mcmba- FDIC
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Rev-1509 EX+ (6-98) '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE T AA RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY -OWNED PROPERTY
Helfer, Anna M.
FILE NUMBER
21 ~07 -00867
ESTATE OF
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME
A. Anne C. Landis
ADDRESS
RELATIONSHIP TO DECEDENT
490 Seedling Court
Mechanicsburg, PA 17055
Daughter
B. Robert C. Jennings
2398 N. Menomonee River Pkway.
Mechanicsburg, PA 17055
Son
c.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY %OF DATE OF DEATH
LETTER DATE
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAllNSTrTUTION AND BANK ACCOUNT DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENT'S INTEREST
JOINTLY-HELD REAL ESTATE
1 A&B 6/21/2004 Morgan Stanley Account #410031007047: 24,482.61 33.333% 8.160.87
TOTAL (Also enter on Line 6, Recapitulation) 8.160.87
(If more space is needed, additional pages of the same size)
Copyright (e) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule F (Rev. 6-98)
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Morgan Stanley
October 3, 2007
S. Dawn Gladfelter
The Wiley Group
130 W Church Street
Suite 100
Dillsburg, PA 17019
RE: Anna M Helfer, Anne C. Landis & Robert Jennings JTTEN
Account # 410-031007-047
Dear Ms. Gladfelter:
Per your letter d3ted September 27, 2007 I have enclosed the August 2007 Chent
Statement and Gain/Loss report for the above mentioned account.
Should you require additional information please give our office a call at 7 17-255-6666
or 1-800-676-0673.
,.sj>>c..e, relY'~, ~/'
U, }~.
, '-.'
Kathleen Benefiel
Sf. Client Service Associate
Investrnems y.J 'CT~:,(e'. 'ife (offered rhr0tlgh l\Aor~a" Stank) & Co. IIlc:\."purateo, member SIPC.
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REV-1151 EX+ (12-99)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Helfer, Anna M.
FILE NUMBER
21-07-00867
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
See continuation schedule(s) attached
2,452.82
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
B.
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City
Year(s) Commission paid
State Zip
2.
Attorney's Fees
The Wiley Group, PC
3,149.25
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
Register of Wills:
335.00
5. Accountant's Fees
6.
Tax Return Preparer's Fees
David J. Lenox:
250.00
7.
Other Administrative Costs
See continuation schedule(s) attached
2,300.66
TOTAL (Also enter on line 9, Recapitulation)
8,487.73
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 5-98)
Rev.1502 EX+ (6-98)
.
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Helfer, Anna M.
FILE NUMBER
21-07-00867
I
ITEM
NUMBER DESCRIPTION
1 Bethany Village - Memorial service:
AMOUNT
150.00
2 Myers Funeral Home:
952.82
3 Quakertown Memorials (tombstone):
1.350.00
Subtotal
2.452.82
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-15DZ EX+ (6-9B)
.
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TM RETURN
RESIDENT DECEDENT
ESTATE OF
Helfer, Anna M.
FILE NUMBER
21-07-00867
ITEM
NUMBER
1
DESCRIPTION
Cumberland Law Journal (advertise estate):
AMOUNT
75.00
2
Register of Wills (filing fee):
30.00
3
Return of funds to Equitable Pension that decedent was not entitled to:
565.08
4
Social Security Administration ~ return of September, 2007 payment:
1.456.00
5
The Sentinel (advertise estate):
174.58
Subtotal
2.300.66
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-151Z EX+ (6-98)
.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVI<Ntl<
INHERITI<NCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Helfer, Anna M.
FILE NUMBER
21-07 -00867
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Bethany Village skilled nursing:
VALUE AT DATE
OF DEATH
154.80
2 FIA Cardservices (credit card):
431.57
3 Millinium Pharmacy:
620.85
4 Millinium Pharmacy:
25.31
TOTAL (Also enter on Line 10, Recapitulation)
1,232.53
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc_
Form PA-1500 Schedule I (Rev. 6-98)
REV-1513 EX+ (9-00)
, SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Helfer, Anna M. 21-07 -00867
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
Do Not List Trustee(s)
I. TAXABLE DISTRIBUTIONS [include outright sfrousal
distributions, and ransfers
under Sec. 9116(a)(1.2)]
1 Daniel R. Helfer Stepchild 3.33333% of
20 W. Laurel Street residuary
Shenandoah,PA 17976 estate
2 Frank P. Helfer Stepchild 3.33333% of
120 Walker Road residuary
Macungie, PA 18062 estate
3 Robert C. Jennings Son 45% of
2398 N. Menomonee River Parkway residuary
Milwaukee, WI 53226 estate
4 Anne C. Landis Daughter 45% of
490 Seedling Court residuary
Mechanicsburg, PA 17055 estate
5 Linda J. Morris Stepchild 3.33333% of
108 Stafford Drive residuary
Blue Bell, PA 19422 estate
Total
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule J (Rev. 6-98)
Jan M. Wiley
David J. Lenox
Timothy J. Colgan
Christopher J. Marzzacco
I
David Eo Hershey
Thomas M. Clark
Angelica L. Revelant
Paul ). Kovatch
THE WILEY GROUP
Attorneys at La"W'
Wiley, Lenox, Colgan & Marzzacco, P.c.
November 27, 2007
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013
In Re: Estate of Anna M. Helfer
No. 21-07-00867
Dear Register:
Enclosed for filing please find an Inventory and the inheritance tax return in duplicate with
regard to the above captioned estate. Also enclosed is a check in the amount of$6,352.09
representing the tax due, and a check in the amount of $30.00 to cover the filing fee.
Please return the recording receiptsto my attention in the enclosed envelope.
Thank you for your cooperation.
Sincerely,
12 .Ill AI A f II-or! I ~J
Dawn~~garts~V
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130 W. Church Street, Suite 100 · Dillsburg, PA 17019 · Phone: (717) 432-9666 · (800) 682-4250 · Fax: (717) 432-0426
Offices in Harrisburg · York · Carbondale
www.wiley4u.com